WEBVTT - Dr. Anthony Fauci 0:00:00.280 --> 0:00:10.280 Hi, I'm Chelsea Clinton, and this is in fact a 0:00:10.360 --> 0:00:14.400 podcast about why public health matters after so much grief, fear, 0:00:14.440 --> 0:00:17.160 and uncertainty. I know many people are eager to put 0:00:17.160 --> 0:00:19.759 COVID nineteen behind us, but we're not out of the 0:00:19.800 --> 0:00:22.840 woods yet, and there are so many lessons that we 0:00:22.960 --> 0:00:25.720 must learn from this pandemic to be better prepared for 0:00:25.760 --> 0:00:29.040 the next one. COVID nineteen isn't the first pandemic that 0:00:29.080 --> 0:00:32.479 has swept the globe. The nineteen eighteen flu pandemic infected 0:00:32.520 --> 0:00:36.040 one third of the world's population, and more recent history, 0:00:36.400 --> 0:00:39.360 the Obama administration created a pandemic playbook for how to 0:00:39.400 --> 0:00:43.280 address quote a high consequence emerging disease threat anywhere in 0:00:43.320 --> 0:00:46.960 the world because public health officials have long worried that 0:00:47.040 --> 0:00:51.240 there could be another global pandemic. So just how unprecedented 0:00:51.360 --> 0:00:53.800 has this last year been, What have we learned from 0:00:53.840 --> 0:00:56.720 past crises, what can we learn from this one? And 0:00:56.760 --> 0:00:59.600 how prepared is our country and our world for the 0:00:59.680 --> 0:01:03.080 next pandemic. We're talking about all of this with someone 0:01:03.120 --> 0:01:05.920 who has become for many the public base of our 0:01:05.959 --> 0:01:11.399 government's response to COVID nineteen, Dr Anthony Faucci, Dr Fauci 0:01:11.520 --> 0:01:14.080 was appointed director of the National Institute of Allergy and 0:01:14.120 --> 0:01:18.360 Infectious Diseases back in during a hugely consequential moment in 0:01:18.400 --> 0:01:22.120 the HIV AIDS pandemic. His research was crucial to understanding 0:01:22.120 --> 0:01:24.280 how the virus works, and he was one of the 0:01:24.360 --> 0:01:27.480 leading architects of the President's Emergency Plan for AIDS Relief 0:01:27.600 --> 0:01:30.480 or pet FAR, which has helped saved millions of lives 0:01:30.520 --> 0:01:34.800 around the world. He's advised seven presidents on how to prevent, diagnose, 0:01:34.880 --> 0:01:39.000 and treat a long list of infectious diseases, including HIV AIDS, 0:01:39.040 --> 0:01:44.680 respiratory infections, diarrheal diseases, tuberculosis, malaria, ebola, and zica. He's 0:01:44.680 --> 0:01:47.440 been leading the U. S government's efforts to combat this pandemic, 0:01:47.560 --> 0:01:51.080 working non stock with his team and communicating consistently and 0:01:51.280 --> 0:01:54.280 honestly with Americans every step of the way. I was 0:01:54.400 --> 0:02:01.360 honored to welcome to the podcast. So, Dr Arouchy, it's 0:02:01.400 --> 0:02:05.400 become almost a cliche to say this is an unprecedented time, 0:02:05.640 --> 0:02:09.560 and I'm just curious, given that you have lived through 0:02:09.919 --> 0:02:13.440 other pandemics, worked in other pandemics, how much of this 0:02:13.560 --> 0:02:19.680 feels unprecedented and how much of it feels eerily familiar. Well, Chelsea, 0:02:19.760 --> 0:02:23.840 the only eerily familiar thing about it is the unpredictable 0:02:23.919 --> 0:02:27.280 nature of outbreaks where you're just going along and then 0:02:27.280 --> 0:02:29.520 all of a sudden something comes up. It could be 0:02:29.720 --> 0:02:33.760 subtle the way HIV This month. In the next few 0:02:33.840 --> 0:02:39.320 days where commemorating the forty anniversary of the realization that 0:02:39.360 --> 0:02:41.400 we were dealing with a new syndrome. We didn't know 0:02:41.480 --> 0:02:44.920 what the microbe, the pathogen was. We didn't even have 0:02:44.960 --> 0:02:49.800 a name for it back in June and July. Having 0:02:49.840 --> 0:02:51.880 had I guess I would call it the privilege in 0:02:51.919 --> 0:02:55.480 some respects, but also the painful experience of being involved 0:02:55.520 --> 0:02:58.200 in that from the very first day, that's sort of 0:02:58.240 --> 0:03:01.840 snuck up on you. It was level below the radar screen. 0:03:02.440 --> 0:03:04.360 Then as we learned more and more about it, we 0:03:04.440 --> 0:03:06.720 found out we were dealing with just the tip of 0:03:06.720 --> 0:03:10.200 the iceberg when we saw people who were very, very sick, 0:03:10.720 --> 0:03:13.440 not knowing until we had a test that we were 0:03:13.440 --> 0:03:17.000 dealing with something where they were literally millions of people infected. 0:03:17.320 --> 0:03:21.960 So the fact that outbreaks are unpredictable, they come in 0:03:22.040 --> 0:03:25.760 strange ways, that's the common denominated the difference with this 0:03:26.680 --> 0:03:31.119 that validates the statement it's unprecedented is that when you're 0:03:31.120 --> 0:03:36.120 dealing with something as explosive as this, which has a 0:03:36.160 --> 0:03:40.760 couple of characteristics that I have often referred to, almost 0:03:41.160 --> 0:03:45.800 ironically years ago, is what is your worst nightmare? Dr Fauci. 0:03:45.840 --> 0:03:48.640 People would ask me that five years ago, ten years ago, 0:03:48.720 --> 0:03:51.720 fifteen years ago, and longer. I would always say it 0:03:51.840 --> 0:03:56.560 was the emergence of a new virus generally jumping species 0:03:56.600 --> 0:03:59.320 from an animal host to a human that had two 0:03:59.480 --> 0:04:05.000 character ristics, one that is extraordinarily efficient in spreading from 0:04:05.080 --> 0:04:09.000 human to human, and two that it has the capability 0:04:09.000 --> 0:04:11.280 of a great degree of morbidity and mortality. And when 0:04:11.320 --> 0:04:14.600 you put those two things together, that's when you get 0:04:14.680 --> 0:04:18.080 my worst nightmare. And that's exactly what we're experienced because 0:04:18.120 --> 0:04:21.279 we have not had anything like this in well over 0:04:21.320 --> 0:04:26.640 a hundred years, since the historic influenza pandemic of nineteen eighteen. 0:04:27.040 --> 0:04:31.520 So there is a very strong true element of this 0:04:31.640 --> 0:04:36.120 being unprecedented, at least in over a hundred years, you know, 0:04:36.160 --> 0:04:39.000 and Dr Patty, there's an adage in public health that 0:04:39.080 --> 0:04:43.320 outbreaks are inevitable, but epidemics aren't. Now, with the benefit 0:04:43.400 --> 0:04:47.800 of both hindsight and your decades of experience in pandemics. 0:04:48.040 --> 0:04:51.159 What do you think we could have done differently in 0:04:51.279 --> 0:04:55.719 January or February to help save American lives and save 0:04:55.800 --> 0:05:00.839 lives across the globe. Yeah, in some respects it is 0:05:00.880 --> 0:05:05.719 not answerable, because you could certainly have done things differently 0:05:05.839 --> 0:05:08.960 if you knew things differently, So you could say to 0:05:09.000 --> 0:05:13.719 yourself in this country, what could we have done if 0:05:13.760 --> 0:05:18.080 we knew back in January? What we know right now 0:05:18.600 --> 0:05:22.000 is the characteristics that I'm telling you. It's extraordinary ability 0:05:22.360 --> 0:05:26.240 to efficiently spread from human to human, the fact that 0:05:26.440 --> 0:05:30.719 fifty to sixty percent of the transmissions occur from someone 0:05:31.040 --> 0:05:34.080 who is infected but has no symptoms at all. We 0:05:34.120 --> 0:05:37.520 know anywhere from a third of the people who get 0:05:37.520 --> 0:05:41.120 infected never develop any significant symptoms at all that would 0:05:41.120 --> 0:05:45.640 bring attention to any medical intervention. So back then, if 0:05:45.680 --> 0:05:49.160 we knew that we were dealing with in this country 0:05:49.600 --> 0:05:53.520 something as extraordinary as this in its ability to spread, 0:05:54.120 --> 0:05:57.159 we would have done something that likely would have not 0:05:57.320 --> 0:06:00.719 been acceptable to the American public. When we had the 0:06:00.760 --> 0:06:04.440 first case, and I think it was January one, to 0:06:04.560 --> 0:06:08.480 say Okay, it's here, and then a few days later 0:06:08.600 --> 0:06:11.280 or a week or two later, it became clear that 0:06:11.320 --> 0:06:14.800 there was community spread. It just there, which means someone 0:06:15.200 --> 0:06:18.719 infected someone and you don't have the chain of transmission 0:06:18.839 --> 0:06:21.200 locked in, you don't know where the person got it from. 0:06:21.360 --> 0:06:24.880 That being the case, that means it's spreading in society 0:06:24.920 --> 0:06:28.640 beneath the radar screen. If we had known its capability 0:06:28.640 --> 0:06:31.160 of spreading, we could have said, let's shut the country 0:06:31.200 --> 0:06:34.560 down right now to prevent it. I think there would 0:06:34.560 --> 0:06:38.160 have been such extraordinary pushback to say, well, wait a minute, 0:06:38.200 --> 0:06:40.320 what are you talking about. We have one or two cases. 0:06:40.640 --> 0:06:43.760 You want to shut the country down. That's crazy. So 0:06:44.120 --> 0:06:46.200 when you asked me a question, what could we have 0:06:46.320 --> 0:06:50.880 done differently, Well, now that we have five and ninety 0:06:50.920 --> 0:06:54.960 thousand deaths, you go back and say, wow, look what 0:06:55.080 --> 0:06:59.040 this is done. We maybe could have prevented some of 0:06:59.080 --> 0:07:02.599 those had we shut down earlier and prevented the spread. 0:07:03.040 --> 0:07:06.279 But you know, if you look throughout the world, Chelsea, 0:07:06.400 --> 0:07:10.720 even countries that appear to have done well early on, 0:07:11.360 --> 0:07:14.960 every country has gotten hit really badly. Even some of 0:07:15.000 --> 0:07:19.080 the Asian countries now that we pointed to as models 0:07:19.120 --> 0:07:22.120 of their response are now starting to get into trouble, 0:07:22.400 --> 0:07:26.880 including places like Taiwan and Singapore and Vietnam and places 0:07:26.920 --> 0:07:29.840 like that, who seemed to have done very well in 0:07:29.880 --> 0:07:33.760 the first waves. You made a comment that resonates with 0:07:33.840 --> 0:07:36.720 me is how do you prevent an outbreak from becoming 0:07:36.760 --> 0:07:40.840 a pandemic? So I don't think we're necessarily going to 0:07:40.880 --> 0:07:44.640 be able to prevent the emergence of new microbes. They've 0:07:44.680 --> 0:07:48.760 occurred historically for as long as and before history even 0:07:48.800 --> 0:07:52.200 recorded it. History is full of them. But in answer 0:07:52.280 --> 0:07:56.040 to your question, how do you prevent that from becoming 0:07:56.080 --> 0:07:59.360 a pandemic? And that's when we talk about lessons learned? 0:07:59.440 --> 0:08:03.120 What can we learn having gone through this where the 0:08:03.200 --> 0:08:09.080 United States was ranked by public health agencies as being 0:08:09.080 --> 0:08:11.840 the best prepared country in the world for a pandemic 0:08:12.320 --> 0:08:15.680 and we got hit among the top three, with Brazil 0:08:15.840 --> 0:08:19.560 and India as the three worst in the sense of 0:08:19.640 --> 0:08:22.360 numbers of cases and deaths and dr bout You do 0:08:22.440 --> 0:08:26.160 you think that that is because we were prepared for 0:08:26.360 --> 0:08:29.040 previous pandemics and not future ones. I mean, were we 0:08:29.240 --> 0:08:31.960 ready to fight the last war and not the next war? 0:08:32.640 --> 0:08:36.120 I think it's partially that, not completely. I think it 0:08:36.240 --> 0:08:39.520 was there were things that went wrong early on, and 0:08:39.559 --> 0:08:42.920 that was the issue with the testing that we didn't 0:08:42.920 --> 0:08:45.640 have a good testing system for a considerable period of time, 0:08:46.160 --> 0:08:50.160 and we were testing only symptomatic people because we're not 0:08:50.400 --> 0:08:55.319 fully aware that asymptomatic spread was really, really, very important. 0:08:55.480 --> 0:08:57.600 So those are the things that I think could have 0:08:57.600 --> 0:08:59.520 been done differently. And then, you know, I don't want 0:08:59.520 --> 0:09:03.640 to read litigate what went on last year, but there 0:09:03.640 --> 0:09:05.480 were things that I think could have been done better. 0:09:06.440 --> 0:09:08.360 Although I live in New York now, I grew up 0:09:08.559 --> 0:09:11.079 in Arkansas and then moved when I was twelve to 0:09:11.240 --> 0:09:14.920 d C. And it is heartbreaking to me Dr Facci 0:09:15.040 --> 0:09:20.719 that Arkansas, Louisiana, Tennessee, Mississippi, so much of the South 0:09:21.280 --> 0:09:25.360 have vaccination rates that are half of what we see 0:09:25.640 --> 0:09:29.000 in the Northeast. Since you've had to communicate now over 0:09:29.080 --> 0:09:33.400 so many decades, so many different public health challenges and 0:09:33.440 --> 0:09:37.440 also imperatives, how do you think we rebuild trust in 0:09:37.520 --> 0:09:42.760 science and especially trust in in vaccines and vaccinations. That 0:09:42.960 --> 0:09:45.840 is something that is not going to happen easily, Chelsea. 0:09:45.960 --> 0:09:49.199 I think that we may have to find ways, and 0:09:50.160 --> 0:09:52.800 that's a complicated issue. As you will know, probably better 0:09:52.840 --> 0:09:56.000 than I do, it's a complicated issue of how you 0:09:56.080 --> 0:10:01.960 heal the differences and the hostility. I mean, I've been 0:10:02.000 --> 0:10:05.160 the object myself of a phenomenal amount of hostility merely 0:10:05.240 --> 0:10:09.439 because I'm promoting what a really fundamental, simple public health 0:10:09.520 --> 0:10:13.559 principles that seems astounding that that would generate a considerable 0:10:13.559 --> 0:10:18.080 degree of hostility, But it is. It is. So I 0:10:18.080 --> 0:10:22.880 don't think the answer is intensifying the hostility and pointing figures. 0:10:22.920 --> 0:10:25.680 I think the approach is to outreach to try and 0:10:25.800 --> 0:10:30.120 understand each other better and realize that we have differences. 0:10:30.160 --> 0:10:33.400 But those differences should be the source of strength in 0:10:33.520 --> 0:10:38.559 some respects and not the source of chaos. So I 0:10:38.920 --> 0:10:41.280 don't I don't know the answer to your question. It's 0:10:41.320 --> 0:10:44.600 a seemingly simple question with a complicated answer. We've got 0:10:44.640 --> 0:10:47.479 to reach out to people and get them to understand 0:10:47.520 --> 0:10:50.400 that this is for their own safety, their own health, 0:10:50.720 --> 0:10:54.840 and also what I refer to as communal responsibility, your 0:10:54.840 --> 0:10:59.600 responsibility to society. Because there is a thing called the 0:10:59.679 --> 0:11:03.040 chain of transmission of an outbreak, and one of the 0:11:03.240 --> 0:11:07.600 very interesting and I must say quite unique aspects of 0:11:07.920 --> 0:11:11.960 saws COVID two and COVID nineteen is that the same 0:11:12.080 --> 0:11:17.560 virus that has killed almost six hundred thousand Americans makes 0:11:18.120 --> 0:11:20.320 many many people have no symptoms at all. It just 0:11:20.400 --> 0:11:24.439 doesn't bother them. I mean, there's the people getting no 0:11:24.520 --> 0:11:29.240 symptoms at all. So that is in many respects unprecedented 0:11:29.280 --> 0:11:32.959 to have that situation. Usually, when you have something as 0:11:32.960 --> 0:11:36.880 potentially deadly as this, it makes just about everybody a 0:11:36.920 --> 0:11:39.760 little bit sick. This is something where there were people 0:11:39.800 --> 0:11:43.320 who were saying, why should I get vaccinated? The chances 0:11:43.360 --> 0:11:46.400 of my getting into trouble are very very low, and 0:11:46.400 --> 0:11:49.800 they're correct. If you look at the rate of hospitalizations 0:11:49.840 --> 0:11:53.840 of young people, it's a non zero. It's small compared 0:11:54.000 --> 0:11:57.000 to the rate among elderly people and among people with 0:11:57.080 --> 0:11:59.840 underlying conditions. But there are a couple of things there 0:11:59.880 --> 0:12:03.480 that people don't fully understand. You're not completely exempt, because 0:12:03.520 --> 0:12:07.640 a lot of young people wind up getting into trouble statistically, 0:12:07.679 --> 0:12:10.599 not nearly as many as the elderly and those with 0:12:10.760 --> 0:12:15.120 underlying conditions. But there's another aspect of it. Let's say 0:12:15.160 --> 0:12:19.760 you get infected and you don't get any symptoms at all, 0:12:19.880 --> 0:12:22.800 and you could say that, see, I got infected, big deal, 0:12:23.440 --> 0:12:27.520 what's the difference. The difference is that it is conceivable 0:12:27.559 --> 0:12:31.240 and maybe likely that even though you've got no symptoms, 0:12:31.280 --> 0:12:35.440 that you would inadvertently and innocently I'll use that word 0:12:35.880 --> 0:12:38.880 pass it on to someone else who would then pass 0:12:38.880 --> 0:12:41.280 it on to someone else who would then get a 0:12:41.360 --> 0:12:45.040 serious consequence. So there is a degree that have to 0:12:45.080 --> 0:12:49.600 consider of what is my societal responsibility of not being 0:12:49.800 --> 0:12:54.040 part of the chain of transmission as opposed to being 0:12:54.080 --> 0:12:57.120 a dead end for the virus. So do you want 0:12:57.120 --> 0:12:59.360 to be a dead end for the virus or do 0:12:59.400 --> 0:13:02.040 you want to be situation where you're part of the 0:13:02.120 --> 0:13:05.319 transmission chain which would get other people in trouble. But 0:13:05.480 --> 0:13:08.600 that's tough to get that concept. I mean, Dr pot 0:13:08.760 --> 0:13:09.959 I never thought I would say I wanted to be 0:13:10.040 --> 0:13:12.920 a dead end, but yes here I am very happy 0:13:13.120 --> 0:13:15.439 to be fully vaccinated in a In a dead end, 0:13:19.000 --> 0:13:32.720 we'll be right back to stay with us. I don't 0:13:32.720 --> 0:13:37.600 want to ask about preparedness because I think probably a 0:13:37.640 --> 0:13:41.920 lot of people are now as we are vaccinating the country. 0:13:42.559 --> 0:13:44.440 I know a lot of people want to put COVID 0:13:44.480 --> 0:13:47.800 in the rear view mirror, leave it in, not worry 0:13:47.840 --> 0:13:51.199 about it again. But we know that the virus is 0:13:51.240 --> 0:13:53.960 not done with us until we have everyone vaccinated and 0:13:53.960 --> 0:13:56.440 we know we need to learn lessons from this to 0:13:56.520 --> 0:14:00.200 help better prepare us going forward. So what less since 0:14:00.240 --> 0:14:02.000 do you think we need to learn, And how do 0:14:02.040 --> 0:14:05.160 you think your work at the NIH has to adapt. 0:14:05.200 --> 0:14:07.880 How do you think the Biden administration has to adapt? 0:14:08.480 --> 0:14:11.559 What concrete things have to happen to ensure we are 0:14:12.320 --> 0:14:16.000 better prepared for the inevitable next time? Okay, so two 0:14:16.040 --> 0:14:19.520 components to my answer to Chelsea. The first is that 0:14:19.560 --> 0:14:21.920 when you're dealing with a global pandemic, you have to 0:14:21.960 --> 0:14:25.440 have a global response. We're not going to be safe 0:14:25.720 --> 0:14:30.760 on this planet until the pandemic is controlled globally, so 0:14:30.920 --> 0:14:36.040 right away it is not necessarily a lesson, but almost 0:14:36.040 --> 0:14:39.800 a mandate that we really need to help the rest 0:14:39.840 --> 0:14:42.520 of the world, as as a rich country, get this 0:14:42.720 --> 0:14:47.760 under control, because if there's still viral dynamics somewhere, even 0:14:47.800 --> 0:14:50.320 if we get this on the very good control here, 0:14:50.840 --> 0:14:54.040 there's always the danger of the generation of variance, which 0:14:54.080 --> 0:14:59.360 then would make our protection somewhat tenuous even with the vaccines. 0:14:59.600 --> 0:15:02.040 That's the first thing when you look at the future, 0:15:02.120 --> 0:15:05.840 what lessons learned for the future, we need to also 0:15:06.120 --> 0:15:09.080 prepare in a global way. There was a thing called 0:15:09.120 --> 0:15:13.400 the Global Health Security Network or the Global Health Security Agenda, 0:15:13.720 --> 0:15:18.160 where you have interconnectivity among countries of the world, good 0:15:18.200 --> 0:15:23.600 modern up to date communications, sharing of re agents, sharing 0:15:23.840 --> 0:15:30.000 of of specimens, continued good collaboration and communication, building up 0:15:30.200 --> 0:15:34.320 in the local areas, the public health infrastructure that would 0:15:34.360 --> 0:15:38.600 allow them to respond and quench something when it breaks 0:15:38.600 --> 0:15:43.520 out in any given country, because outbreaks generally don't start 0:15:44.200 --> 0:15:48.720 spontaneously in twenty five countries. They generally start as a 0:15:48.800 --> 0:15:52.720 jumping of species, usually not always from an animal reservoir 0:15:52.760 --> 0:15:54.880 to a human and then it spreads to the rest 0:15:54.880 --> 0:15:56.920 of the world. That doesn't mean that you've got to 0:15:56.960 --> 0:16:00.200 blame the country where it happens. It just so happens, 0:16:00.200 --> 0:16:03.600 but you've got to have those countries prepared to be 0:16:03.680 --> 0:16:06.760 able to contain it. So that's the thing with preparedness. 0:16:06.800 --> 0:16:10.480 The other thing from a scientific standpoint is that we 0:16:10.560 --> 0:16:15.560 are very fortunate that we have made decades and decades 0:16:15.600 --> 0:16:20.120 of investment in basic and clinical biomedical research, which has 0:16:20.160 --> 0:16:24.080 allowed us to do something that's unprecedented, to get a 0:16:24.160 --> 0:16:28.480 vaccine in which a virus was first identified in January 0:16:28.480 --> 0:16:32.600 of and then in December of that same year, eleven 0:16:32.640 --> 0:16:39.080 months later to be putting vaccine into people's arms. That's efficacious. 0:16:39.480 --> 0:16:42.680 If we were having this conversation ten years ago, you 0:16:42.680 --> 0:16:46.280 would have told me I was completely crazy thinking that 0:16:46.280 --> 0:16:49.720 that would happen. It usually takes years and years. And 0:16:49.800 --> 0:16:53.760 the speed was not because we were reckless in doing 0:16:53.800 --> 0:16:57.800 things and cutting corners. The speed was related to the 0:16:57.880 --> 0:17:01.320 extraordinary amount of in u stament that was made of 0:17:01.360 --> 0:17:05.880 the previous decades in clinical and basic research. So there 0:17:05.880 --> 0:17:09.800 are another component of lessons learned. We need to continue 0:17:10.040 --> 0:17:14.399 to make the investments in research that will allow us 0:17:14.680 --> 0:17:18.840 to have the scientific component of the response be optimal. 0:17:19.040 --> 0:17:22.320 And fortunately for us, that's what happened with regard to 0:17:22.359 --> 0:17:26.400 the vaccines. Dr P. You you mentioned earlier the Global 0:17:26.440 --> 0:17:32.479 Health Security Agenda, which while it had antecedents over many years, 0:17:32.560 --> 0:17:36.600 really got codified in the aftermath of a Bola and 0:17:36.680 --> 0:17:39.880 of the United States saying what has happened in Western 0:17:39.880 --> 0:17:43.639 Africa is clearly a tragedy for people there, but it 0:17:43.760 --> 0:17:46.320 is a danger to us here too, and we do 0:17:46.400 --> 0:17:52.199 need to have more robust public health architecture everywhere. And 0:17:52.240 --> 0:17:56.800 then that wasn't a priority for the Trump administration, but 0:17:56.840 --> 0:17:59.760 it wasn't really a priority for the world. I do 0:18:00.040 --> 0:18:03.200 admittedly have a little bit of a concern that once 0:18:03.240 --> 0:18:06.800 we are through COVID nineteen, I worry we might lose 0:18:06.840 --> 0:18:12.280 focus on the need to build robust global architecture to 0:18:12.280 --> 0:18:16.800 help protect public health everywhere. Well, Chelsea, I definitely share 0:18:16.840 --> 0:18:19.600 your concern, and the reason I do is from my 0:18:19.720 --> 0:18:24.280 experience in that corporate memory for things that I've been 0:18:24.400 --> 0:18:27.639 very very difficult in the sense of responding and preparing 0:18:28.040 --> 0:18:31.800 is often short lived, and when you put this behind us, 0:18:32.280 --> 0:18:36.720 we will be dealing with problems that are real and present. 0:18:37.240 --> 0:18:41.359 Yet it's difficult to get people to understand that the 0:18:41.440 --> 0:18:46.000 threat of an outbreak is perpetually a real and present danger. 0:18:46.520 --> 0:18:49.000 So what we've got to do as a globe, as 0:18:49.080 --> 0:18:52.359 as a planet, as a community of nations is to 0:18:52.560 --> 0:18:55.840 just make sure we tell ourselves that when we get 0:18:55.880 --> 0:18:59.400 this under control, that we've got to say never again 0:18:59.680 --> 0:19:03.280 and need it, and never again means to really put 0:19:03.320 --> 0:19:07.439 the effort into the kind of preparation that will require 0:19:07.640 --> 0:19:13.240 considerable resources. And even though it's tough to convince people 0:19:13.600 --> 0:19:18.080 to give resources to something that isn't happening. Now, we've 0:19:18.119 --> 0:19:21.400 got to call back the memory of two thousand nine 0:19:23.720 --> 0:19:26.399 one because as we started off in the beginning of 0:19:26.480 --> 0:19:30.359 this podcast, the fact is that this is really what 0:19:30.600 --> 0:19:33.919 happened to us. It just came out of nowhere, and 0:19:33.960 --> 0:19:39.240 it just immobilized us for such an extraordinary period of time. 0:19:39.280 --> 0:19:42.960 And we're in our second year now. The economy has 0:19:43.000 --> 0:19:46.040 been wrecked by this for sure, not only here in 0:19:46.080 --> 0:19:49.680 the United States. Thank goodness, we're recovering now, but it's 0:19:49.720 --> 0:19:52.200 still a lot of people out of work. I think 0:19:52.240 --> 0:19:56.120 those kinds of memories should spur us on to make 0:19:56.119 --> 0:19:59.680 sure we are adequately prepared next time around. Well, and 0:19:59.720 --> 0:20:02.560 hope we will spur us on. Returning to a comment 0:20:02.600 --> 0:20:04.760 that you made earlier that I am in vigorous agreement 0:20:04.840 --> 0:20:08.119 with that we have responsibility to help vaccinate the world. 0:20:08.320 --> 0:20:12.960 And while I certainly appreciate President Biden's commitment to donate 0:20:13.000 --> 0:20:16.119 seventy million doses by July four, we know we can't 0:20:16.280 --> 0:20:20.199 effectively donate our way out of this. So I am 0:20:20.240 --> 0:20:23.760 curious Dr about you if we think about the architecture 0:20:24.320 --> 0:20:26.960 that we really need to help protect public health globally. 0:20:27.080 --> 0:20:32.280 While often the focus is on surveillance and specimen collecting, testing, 0:20:32.840 --> 0:20:36.040 what do you think it should be for vaccine research 0:20:36.080 --> 0:20:40.400 and development, for example, or the actual ability to manufacture 0:20:40.480 --> 0:20:44.520 and to guarantee the quality of vaccines in the next generation. 0:20:45.320 --> 0:20:48.359 I'm with you on that, and that is referring to 0:20:48.600 --> 0:20:53.399 building up the capacity and the ability to do technology 0:20:53.440 --> 0:20:57.359 transfer so that when you have an outbreak, it isn't 0:20:57.480 --> 0:21:01.520 only companies in Switzerland, the United States and the UK, 0:21:02.240 --> 0:21:06.520 but you have plants and companies and technology and the 0:21:06.640 --> 0:21:10.439 knowledge to do it in Senegal and Ethiopia and South 0:21:10.480 --> 0:21:15.000 Africa and Indonesia and Brazil and Chile, so that when 0:21:15.040 --> 0:21:18.119 you have an outbreak, you do have the capability. And 0:21:18.160 --> 0:21:22.000 that is building up not only the infrastructure of public 0:21:22.000 --> 0:21:26.760 health to do surveillance and monitoring, but also the ability 0:21:26.840 --> 0:21:31.879 to respond at a global level. To rely on donations 0:21:32.640 --> 0:21:38.800 is a quick, immediate, partial fix, but the real durable, 0:21:39.240 --> 0:21:43.560 sustainable fix now in the future is to allow other 0:21:43.720 --> 0:21:47.920 countries that generally don't have that capacity to be able 0:21:47.960 --> 0:21:51.880 to make vaccine in a timely fashion and not depend 0:21:51.920 --> 0:21:55.480 completely on donations from the rich country. The rich country 0:21:55.480 --> 0:21:58.840 should donate if they have to, but the real ultimate 0:21:58.880 --> 0:22:02.879 solution is to have a world where it's evenly distributed, 0:22:02.920 --> 0:22:07.040 with his equity and opportunity to make your own countermeshes. 0:22:07.040 --> 0:22:13.960 In this case, it would be vaccines and therapeutics. We're 0:22:14.000 --> 0:22:26.280 taking a quick break, stay with us, Dr pot You 0:22:26.320 --> 0:22:28.600 mentioned earlier that you've been under quite a bit of 0:22:28.800 --> 0:22:32.159 personal attack for talking about things that should be I 0:22:32.200 --> 0:22:36.040 would argue like fairly non controversial, like the importance of vaccines, 0:22:36.040 --> 0:22:39.080 of vaccinations. And we know that so many of our 0:22:39.119 --> 0:22:44.760 public health officials have been under in noorminate stress, working 0:22:44.920 --> 0:22:48.160 day after day without rest to try to help protect 0:22:48.400 --> 0:22:50.639 public health over the last year and a half. And 0:22:51.000 --> 0:22:54.040 we know that many public health officials have also received 0:22:54.920 --> 0:22:58.120 horrific abuse, and that the mental health toll has been 0:22:58.160 --> 0:23:01.159 really immense. What do you think we need to do 0:23:01.320 --> 0:23:04.199 to try to help support everyone who's really been on 0:23:04.240 --> 0:23:09.480 the front lines to recover from this horrifically stressful time 0:23:09.520 --> 0:23:14.880 is hopefully we recover as a country. Yeah, well, you're 0:23:14.920 --> 0:23:18.639 pointing out something that I think everyone hopefully will ultimately 0:23:18.640 --> 0:23:23.120 recognize is the extraordinary courage and effort that has been 0:23:23.119 --> 0:23:25.800 put in by our frontline health care workers. I mean, 0:23:25.840 --> 0:23:28.320 they truly are the heroes and the heroines of this 0:23:29.200 --> 0:23:32.920 the physical risk that they took are taking to take 0:23:32.960 --> 0:23:36.879 care of people. The physical and mental strain of seeing 0:23:36.960 --> 0:23:40.960 people every single day dying right in front of you 0:23:41.040 --> 0:23:43.040 with very little that you can do, particularly when you're 0:23:43.080 --> 0:23:46.720 dealing with people who have underlying conditions in which when 0:23:46.760 --> 0:23:50.440 they get hospitalized, there and very very difficult straits. It's 0:23:50.440 --> 0:23:54.359 a reality. We've lost close to five nine people in 0:23:54.400 --> 0:23:57.800 this country. That's terrible for the losses of those people 0:23:57.800 --> 0:24:00.359 and their families. But what people don't a pre cate 0:24:00.560 --> 0:24:03.080 because I've been there. I've been there, and I know 0:24:03.160 --> 0:24:07.080 what what it means, the terrible strain and stress when 0:24:07.119 --> 0:24:09.640 you're trying your best to save someone's life and they 0:24:09.680 --> 0:24:12.960 just lose. You lose them person after person at the person. 0:24:13.720 --> 0:24:17.560 We've got to pay attention to the stress and probably 0:24:17.600 --> 0:24:20.400 a good degree of post traumatic stress that those people have. 0:24:20.480 --> 0:24:24.359 So I think attention to mental health issues is something 0:24:24.440 --> 0:24:27.760 we really absolutely have a responsibility to do for people 0:24:27.920 --> 0:24:31.600 who have given it everything and yet have exhausted themselves 0:24:31.600 --> 0:24:34.520 in the process. Your dr pot, I want to be 0:24:34.600 --> 0:24:36.680 respectful your time. I also want to end on an 0:24:36.960 --> 0:24:41.520 optimistic note. We spoke earlier about how the COVID nineteen 0:24:41.640 --> 0:24:47.439 vaccines were accelerated through just extraordinary amounts of attention and 0:24:47.520 --> 0:24:52.119 investment and collaboration really across the globe, and so I 0:24:52.240 --> 0:24:55.600 just I'm curious what else that is being worked on 0:24:55.720 --> 0:24:58.520 currently at the n I H. Do you think is 0:24:58.520 --> 0:25:02.320 close to a breakthrough and that could similarly really help 0:25:02.640 --> 0:25:06.560 save and protect a lot of lives soon. Yeah, and 0:25:06.720 --> 0:25:10.600 it's in multiple fields of medicine, not just infectious disease. 0:25:10.640 --> 0:25:13.080 But one of the things that we're having a lot 0:25:13.119 --> 0:25:16.399 of optimism now. You know, we've done spectacularly well in 0:25:16.440 --> 0:25:20.240 the development of life saving drugs for persons living with HIV, 0:25:20.480 --> 0:25:23.200 to the point now if you're infected, you get put 0:25:23.240 --> 0:25:26.760 on one pill that contains three drugs and you can 0:25:26.800 --> 0:25:30.840 go essentially lead to almost a normal lifespan. So we've 0:25:30.880 --> 0:25:33.600 done well there. The thing that has been the challenge 0:25:33.640 --> 0:25:37.199 is a vaccine for HIV. But I believe some of 0:25:37.200 --> 0:25:41.480 the technologies that have been developed and shown to be 0:25:41.560 --> 0:25:45.200 highly successful, like the MR and a vaccine platform technology 0:25:45.480 --> 0:25:49.280 for COVID nineteen is now being actively pursued in the 0:25:49.280 --> 0:25:53.119